For those with type 2 diabetes who are difficult to manage, doctors may recommend switching to a different treatment.
Tirzepatide, often referred to by its brand moniker Mounjaro, is used as a first-line treatment for diabetes.
A new study suggests that the medication may be used as an adjunct therapy for patients being prescribed slow-acting and fast-acting insulin during mealtimes.
The results of the study show that the addition of tripeptide to a program of slow-acting insulin was more efficient than fast-acting insulin in the reduction of A1CTrusted Source and aiding in weight loss. It also had lower incidences of hypoglycemia among patients with uncontrolled diabetes.
Researchers published their findings on the 3rd of October in JAMATrusted Source, a medical journal. JAMATrusted Source in light of their results from the SURPASS-6 clinical trial that was randomized. The problem was funded by Eli Lilly, the pharmaceutical company that created Mounjaro.
“Tirzepatide as an add-on to basal insulin treatment at individual and pooled doses resulted in statistically significant and clinically significant reductions in mean HbA1C… This glycemic efficacy was associated with weight loss and a lower rate of clinically significant hypoglycemia,” the authors wrote.
Members of the American Diabetes Association applauded the trial’s results:
“The ADA Standards of Care suggests individualized weight loss goals to those who suffer from obesity and diabetes. Recent research has demonstrated Tirzepatide to be a successful medicine option to lower your body’s mass in a clinically significant manner,” Dr. Robert Gabbay, Chief Science and Medical Officer of the American Diabetes Association, told Healthline.
“The results of SURPASS-6 further support the role of Tirzepatide in treatment of individuals with type 2 on insulin and obesity.”
Is Mounjaro an insulin-like alternative?
The main objective of the study was to determine whether tripeptide is as safe and effective as insulin with fast-acting properties in reducing A1C in 52 weeks. Loss of weight or preventing weight gain was a second outcome that was observed during the study.
“Open-label” trial “open-label” trial included 1,428 participants. The test was conducted from October 2020 to November 2022. The open label refers to participants as well as physicians being informed of the medication being used. Patients needed to be at minimum 18 years old, as well as have an A1C between 7.5, 10%, and 11 percentage.
In the context of diabetes, A1C is a shorthand term for hemoglobin A1C, also known as HbA1c, which is the quantity of hemoglobin present in the blood that contains sugar (glucose) attached to it during the past three months.
The greater the percentage, the more elevated your blood sugar levels.
The National Institute of Diabetes and Digestive and Kidney DiseasesTrusted Source defines A1C levels as:
- healthful: below 5.7%
- prediabetes: 5.7-6.4%
- Diabetes: 6.5% or more than
All participants were prescribed a slow-acting baseline insulin ( insulin glargine). The participants were “randomized” to receive either another rapid-acting insulin (insulin lispro) or three different dosages of the drug tripeptide (5mg, 10, 10 mg, or 15 mg). After being randomized to different groupings of intervention, participants were monitored for 52 weeks.
After that time, the researchers examined the effects of different doses of tripeptide contrasted with fast-acting insulins, both separately and in a pooled cohort.
The researchers found that the group pooled (all the patients who took tripeptide) was able to achieve a mean increase of -2.1 percent, compared to -1.1 percent for those who received fast-acting insulin nearly double. The percentage change in the reduction of A1C was also dependent on the dose.
Five mg of tripeptide experienced a -1.9 percent increase in A1C, compared to -2.2 percent for those who took 10 mg and -2.3 percent for the 15mg group.
The researchers also wanted to find out how many participants attain a certain threshold of A1C of 6.5 percent, which would indicate a shift to the prediabetic range of blood glucose.
Over half (56 percent) of patients in the pooled tripeptide treatment group met this threshold, but only 22% of the insulin fast-acting group did.
A second threshold of 5.7 percent, which could place participants within an acceptable A1C range, was also considered, and it found that 18% who were in the group tripeptide met the threshold. In contrast, only 3% of those in the insulin fast-acting group could be seen to be in an acceptable range.
Dr. Marina Basina, Clinical Professor of MedicineEndocrinology, Gerontology, and Metabolism at Stanford Medicine, said that the study demonstrated how the drug could provide alternative treatment for people who have short-acting insulin that isn’t managing the blood sugar level. Basina did not participate in the research.
“Fasting sugar levels were less significantly reduced in the Moujaro treatment groups when compared to insulin at mealtime. In addition, the insulin doses for basal were reduced by 30 percent at the moment of the introduction of the treatment compared to the usual procedure of reducing the dose by 10-20%.” Basina said.
“This fact is a good sign that we are able to be more aggressive in reducing the dosage of insulin once we start the treatment.
How does Mounjaro affect losing weight?
The loss of weight was also an important outcome of the trial. However, it should not have come as a shock.
Tirzepatide is a member of a group of drugs referred to as GLP-1 receptor agonists that resemble glucagon. Source GLP-1s, or GLP-1s for short. It is similar to the class of medications that are Ozempic as well as Wegovy, two drugs that are marketed for treating obesity.
The main ingredient in these medications is semaglutide, not tripeptide; however, both are GLP-1s and have a number of similarities in their interactions with the body.
A previous investigation found an earlier study that Mounjaro was more effective in weight loss than Ozempic.
Following 52 weeks of treatment, those in the pooled group of tripeptide shed about 20 pounds. At the same time, those who took fast-acting insulin lost about five pounds.
Similar to other results, the weight loss was dependent on the dose. Those who were taking greater amounts of tripeptide lost more than 22.5 pounds for people who took 15mg and around 13 pounds for those who took 5 mg.
What are the potential risks from insulin as well as Mounjaro?
Safety was also a primary goal of the trial, particularly in cases where there was hypoglycemia True source (low glucose levels) that could pose a risk to life. Consequence of taking the diabetes treatment.
Eighteen deaths took place during the study, but none of them could be linked to the research the study.
Although there were a greater number of adverse events in people who used tripeptide, there were more serious adverse events in those who used fast-acting insulin. Of these, hypoglycemia was the most prevalent.
Tirzepatide was significantly less likely to show instances of hypoglycemia that was clinically significant and low blood sugar levels than the insulin fast-acting group.
Hypoglycemia was observed in 12 percent (5mg), 9 9percent (10mg), and 11 percent (15mg) of patients who took tripeptide.
Additionally, more than half (48 percent) of the participants in the fast-acting insulin group had hypoglycemia.
Similar to other GLP-1s mo, moderately severe digestive problems are the most frequently reported side effects of tripeptide. Most often, reports covered:
- nausea
- vomiting
- diarrhea